Lower Back Pain
Expert Lower Back Pain Treatment in Bergen County, New Jersey.
Lower back pain is the most common reason adults visit a spine specialist, and one of the most misunderstood. It is not a diagnosis in itself. It is a symptom. And that distinction matters more than most people realize, because treating lower back pain without identifying its true cause is one of the main reasons patients end up suffering for years longer than they should.
The lower back, or lumbar spine, is made up of five vertebrae that bear the majority of the body’s weight with every movement you make. It is constantly under load. Over time, or after an injury, the structures within and around the lumbar spine can break down, compress nerves, or become inflamed in ways that produce pain ranging from a dull, persistent ache to sharp, debilitating agony that radiates all the way down the leg.
At Spine Care New Jersey, Rishi N. Sheth, MD approaches every case of lower back pain the same way: by finding out exactly what is causing it. Not guessing. Not treating a symptom and hoping for the best. A thorough evaluation, the right imaging, and an honest conversation about what your options actually are.
SymptomsWhen Lower Back Pain Is Telling You Something Important.
Most people experience lower back pain at some point in their lives. A pulled muscle from lifting, a stiff back after a long flight, soreness after a day of yard work. That kind of pain usually resolves within a few days to a couple of weeks with rest and basic care.
But there is another kind of lower back pain that does not go away. The kind that wakes you up at night, makes sitting at your desk unbearable, or sends a sharp electric sensation shooting down your leg every time you take a step. That is the kind that deserves a proper evaluation from a spine specialist.
The following symptoms are particularly important to pay attention to.
Pain that radiates from the lower back down into the buttock, thigh, calf, or foot on one side of the body. This pattern is known as sciatica and is typically caused by a compressed nerve in the lumbar spine.
Numbness or tingling in one or both legs, the feet, or the toes. This is a sign of nerve involvement and should not be dismissed as pins and needles.
Weakness in one leg, difficulty lifting the foot, or a change in your normal walking pattern. Progressive leg weakness in particular is a symptom that warrants prompt evaluation.
Lower back pain that is significantly worse when sitting for extended periods, standing for a long time, walking downhill, or bending forward. Each of these patterns points toward different underlying causes.
Pain that worsens at night or when lying flat. Many patients ask why their lower back hurts when they lay down. This can indicate disc pathology, nerve compression, or in rare cases something that requires more urgent attention.
Any loss of bladder or bowel control accompanied by lower back pain or leg weakness requires emergency evaluation. This combination of symptoms may indicate cauda equina syndrome, which is a surgical emergency.
CausesLower Back Pain Has Many Causes. The Right Diagnosis Changes Everything.
One of the most important things Rishi N. Sheth, MD can do for a patient with chronic lower back pain is give them an accurate diagnosis. It sounds simple, but a surprising number of patients come to Spine Care New Jersey having been told for years that their MRI shows nothing significant, when a more careful review reveals the precise structural cause of their pain.
These are the most common conditions that cause lower back pain in adults.
Herniated or Bulging Disc
When the soft center of a spinal disc pushes through its outer layer and compresses a nearby nerve, the result is often severe lower back pain combined with radiating leg pain, numbness, or weakness. This is one of the most common sources of lumbar pain in adults under 50.
Lumbar Spinal Stenosis
As the spine ages, the spinal canal can narrow due to bone overgrowth, thickened ligaments, or degenerative changes. This narrowing compresses the spinal cord and nerve roots, causing lower back pain that is often accompanied by leg cramping, heaviness, or pain with walking that improves when sitting down.
Degenerative Disc Disease
Over time, spinal discs lose their height and water content, reducing their ability to absorb shock between vertebrae. Degenerative disc disease is an extremely common source of chronic lower back pain, particularly in adults over 40.
Spondylolisthesis
This condition occurs when one vertebra slips forward over the one beneath it, placing stress on nearby nerves and causing lower back pain, leg pain, and sometimes a visible change in posture or gait.
Facet Joint Disease
The facet joints connect the vertebrae to each other and allow the spine to move. Arthritis and inflammation of these joints is a frequent but underdiagnosed cause of axial lower back pain, particularly in older adults.
Sacroiliac Joint Dysfunction
The sacroiliac joints connect the base of the spine to the pelvis. When they become inflamed or dysfunctional, they produce lower back and buttock pain that is often mistaken for a lumbar disc problem.
TreatmentsStarting with the Right Treatment, Not the Most Aggressive One.
There is no single treatment that works for every patient with lower back pain. The right approach depends entirely on what is causing the pain, how long it has been present, how severe the symptoms are, and how significantly it is affecting your life. Rishi N. Sheth, MD evaluates all of these factors carefully before making any recommendation.
Surgery is rarely the right first step. For the vast majority of lower back pain patients, a well-structured non-surgical treatment plan provides meaningful and lasting relief.
Non-Surgical Treatments
Physical Therapy
Physical therapy is often the most valuable non-surgical tool for lower back pain. A properly designed program targets the specific muscles and movement patterns contributing to your pain, builds core stability that takes pressure off the lumbar spine, and teaches you how to move in ways that protect the spine long-term.
Epidural Steroid Injections
Epidural steroid injections deliver anti-inflammatory medication directly to the space surrounding an inflamed or compressed nerve root. For patients with lower back pain and radiating leg pain caused by a herniated disc or spinal stenosis, a well-placed epidural injection can provide significant relief and allow a patient to participate more fully in physical therapy.
Transforaminal Injections
Transforaminal injections offer a more targeted approach, delivering medication directly to the specific nerve root involved. Medial branch blocks and facet joint injections are used for patients whose lower back pain originates primarily from the facet joints. Conservative pain management with anti-inflammatory medications, muscle relaxants, or nerve pain medications may be appropriate as part of a short-term plan.
SURGICAL TREATMENTS
Surgical treatment for lower back pain is recommended only when conservative care has not produced adequate relief, when there is clear structural pathology on imaging that explains the symptoms, or when neurological compromise is present or worsening.
Microdiscectomy
Microdiscectomy is the most commonly performed minimally invasive procedure for a lumbar herniated disc causing significant leg pain. It relieves nerve compression with a small incision and a short recovery.
Spinal decompression
Spinal decompression, also called laminectomy, is performed for lumbar spinal stenosis when the narrowing of the spinal canal is causing significant and disabling symptoms that have not responded to non-surgical care.
Sacroiliac joint fusion
Sacroiliac joint fusion is a minimally invasive procedure for patients with confirmed sacroiliac joint dysfunction that has not responded to conservative measures.
Lumbar disc replacement
Lumbar disc replacement with the ProDisc-L system is an alternative to fusion for carefully selected patients, preserving natural motion at the treated level. Rishi N. Sheth, MD is ProDisc-L certified, one of the few spine surgeons in New Jersey with this specific training.
The Right Diagnosis First. The Right Treatment Second.
Patients come to Spine Care New Jersey from all over Bergen County and northern New Jersey, and many of them share a similar story. They have been living with lower back pain for months or years. They have seen multiple doctors. Some have been told nothing is wrong. Others have been told they need major surgery. Many are simply frustrated and do not know who to trust.
Rishi N. Sheth, MD's approach starts with listening. Understanding the full picture of a patient's pain, their lifestyle, their goals, and their concerns before ever looking at an image or recommending a treatment. Because lower back pain is one of the most over-treated and under-diagnosed conditions in medicine, and the difference between a patient who gets better and one who does not often comes down to whether the right diagnosis was made in the first place.
As the only spine neurosurgeon in Bergen County fellowship-trained at Memorial Sloan Kettering Cancer Center, Rishi N. Sheth, MD brings a depth of diagnostic and surgical expertise to every lower back pain case that is simply not available at most practices in New Jersey. And
as a boutique private practice dedicated exclusively to the spine, every patient benefits from direct, unhurried access to their surgeon at every stage of their care.
Common Questions About Lower Back Pain Treatment at Spine Care New Jersey.
Lower back pain refers to discomfort or stiffness in the lumbar region of the spine. It can range from mild to severe and may be temporary (acute) or long-lasting (chronic).
Lower back pain causes include poor posture, muscle strain, sedentary lifestyle, heavy lifting, injuries, herniated discs, arthritis, and underlying conditions like osteoporosis.
Chronic lower back pain is pain that persists for more than 12 weeks, even after the initial injury or cause has been treated. It may require long-term management, including physical therapy and lifestyle changes.
Sitting, especially for long periods, puts increased pressure on the spinal discs. Poor posture and lack of lumbar support can further strain muscles and ligaments, worsening the pain.
Radiating pain is often due to nerve compression, commonly associated with sciatica or a herniated disc. The pain can travel from the lower back down through the buttock and leg.
A lower back sprain occurs when ligaments in the lower back are overstretched or torn, usually due to sudden movements, twisting, or improper lifting techniques.
You should consult a doctor if the pain lasts more than a few weeks, is severe, radiates to the leg, or is accompanied by numbness, weakness, or loss of bladder/bowel control.
Yes, regular exercise, maintaining a healthy weight, proper posture, ergonomic seating, and safe lifting techniques can help prevent lower back pain.